Increasing Equity in Medical Student Neurosurgery Education Through Distance Learning.

Abstract

Addressing equitable opportunities for medical student (MS) education is important for minimizing disparities in neurosurgical care. However, international MSs, particularly from low- and middle-middle income countries (LMICs) may lack access to educational opportunities compared with their contemporaries in high-income countries. We compare the usefulness of virtual neurosurgery training camps (VNTC) between U.S. and international MSs. A survey assessing demographics, baseline interests, and ratings of usefulness was sent to attendees after the VNTC. Ratings were compared between international and U.S. MSs. Thirty-three (27.7%) of 119 attendees were international MSs, of whom 24 (72.7%) were from LMICs. International MSs were more likely to hold an advanced degree (P = 0.0009), more likely to be MS3/MS4s (P = 0.0111) or postdoctoral (P < 0.0001), and less likely to be MS1/MS2s (P = 0.0059). After the VNTC, international MSs reported greater increase in interest in neurosurgery in general (P = 0.0009) and subspecialties of spine (P = 0.0002), peripheral nerve (P = 0.002), vascular (P = 0.0468), functional/epilepsy (P = 0.001), pediatric (P = 0.0285), and trauma/neurocritical care (P = 0.0067). International MSs reported greater post-VNTC willingness to pursue a career in neurosurgery (P = 0.0001), likelihood of taking a year off during medical school (P = 0.0363), and preparedness for subinternships (P = 0.0003). International MSs reported greater increases in awareness of burnout (P = 0.0157) and work-life balance in neurosurgery (P = 0.0249). International MSs experience prolonged periods of education before applying to residency and have unmet informational needs. Distance learning is useful for international MSs. MS neurosurgery education, through online platforms, represents a long-term strategy for addressing disparities in neurosurgical care worldwide.